Keloid

Gary W. Cole, MD, FAAD

Dr. Cole is board certified in dermatology. He obtained his BA degree in bacteriology, his MA degree in microbiology, and his MD at the University of California, Los Angeles. He trained in dermatology at the University of Oregon, where he completed his residency.

Melissa Conrad Stöppler, MD

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

What is a keloid?

Keloids can be considered to be "scars that don't know when to stop." A keloid, sometimes referred to as a keloid scar, is a tough heaped-up scar that rises quite abruptly above the rest of the skin. It usually has a smooth top and a pink or purple color. Keloids are irregularly shaped and tend to enlarge progressively. Unlike scars, keloids do not subside over time.

What is the difference between a keloid and a hypertrophic scar?

After the skin is injured, the healing process usually leaves a flat scar. Sometimes the scar is hypertrophic, or thickened, but confined to the margin of the wound. Hypertrophic scars tend to be redder and may subside by themselves (a process which can take one year or more). Treatment, such as injections of cortisone (steroids), can speed this process.

Keloids, by contrast, may start sometime after the injury and extend beyond the wound site. This tendency to migrate into surrounding areas that weren't injured originally distinguishes keloids from hypertrophic scars. Keloids typically appear following surgery or injury, but they can also appear spontaneously or as a result of some slight inflammation, such as an acne pimple on the chest (even one that wasn't scratched or otherwise irritated). Other minor injuries that can trigger keloids are burns and body or ear piercings.

What are keloid symptoms and signs?

Keloids are raised and look shiny and dome-shaped, ranging in color from pink to red. Some keloids become quite large and unsightly. Aside from causing potential cosmetic problems, these exuberant scars tend to be itchy, tender, or even painful to the touch.

Treatment of Keloids

For what conditions are cortisone injections used?

Cortisone injections can be used to treat the inflammation of small areas of the body (local injections), or they can be used to treat inflammation that is widespread throughout the body (systemic injections).